CHARLES GLEN MICKELSON

SOUTH ST. PAUL,, MN
NPI1568773679
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224L00000X 
Enumeration Date2010-06-24
Last Update Date2010-11-09
Business Address
Mr. CHARLES GLEN MICKELSON C.Ped.
423 12TH AVE. NORTH
SOUTH ST. PAUL,, MN 55075-1915
Phone number: 651-291-7000
Mailing Address
Mr. CHARLES GLEN MICKELSON C.Ped.
423 12TH AVE. NORTH
SOUTH ST. PAUL,, MN 55075-1915
Phone number: 651-291-7000